Learn what you can do about that build-up of bacteria in your tonsils.

Think of your tonsils as glandular traps. These traps guard the inside of your body by catching incoming bacteria and viruses passing through your mouth and down your throat. Like sponges, they have holes and crevices. When bacteria, food particles, mucous and dead skin and cells become trapped, they clump together into a tonsil stone.

Tonsil stones, also called tonsilloliths, begin as soft, white clumps that might not even be visible. Over time, however, they can calcify and harden into stones. In either form, they are generally harmless, but their presence can signal more serious health issues such as infection, tonsillitis and poor oral hygiene.

Symptoms of a tonsil stone include:

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  • Bad breath
  • Visible white matter caught within the tonsil’s folds
  • Ear pain
  • Swollen tonsils
  • Sore throat
  • Difficulty swallowing, especially if the stone is large
  • Pain when the outside of the throat is touched

In some cases, you may see white gelled clumps in your tonsils but have no symptoms at all.

Removing tonsil stones

In most cases, removing a tonsil stone can be done at home. Using a cotton swab, gently push on the tonsil behind the stone to force the stone out. Vigorous coughing and gargling can dislodge stones as well. Once the stone is out, gargle with salt water to remove any remaining bacteria.

For larger stones that won’t budge, or if you have symptoms of a tonsil stone but don’t see one in your throat, it’s time to consult a doctor.

Procedures for removing stubborn tonsil stones include:

  • Salt water gargles
  • Numbing your throat so that the doctor can manually remove the stone.
  • Tonsil stones can be removed in an outpatient visit
  • Tonsillectomy to permanently remove the tonsils and therefore eliminate tonsil stones altogether.

“Generally, manual removal and salt water gargles are the way to go, with antibiotics reserved for acute flares,” Says Eric J. Kezirian, MD, MPH, professor of sleep medicine at the Keck School of Medicine of USC and otolaryngologist at the USC Caruso Department of Otolaryngology – Head and Neck Surgery at Keck Medicine of USC. “If tonsil stones recur often enough, tonsillectomy is warranted.”

Preventing tonsil stones

The only proven way to present tonsil stones is to remove your tonsils, but you can reduce their occurrence by intensifying your oral hygiene routine. Be sure to brush your teeth at least twice daily, gargle with an antiseptic or salt water and drink water after eating to flush away any food remaining in your throat. Smoking may also be a culprit, so consider quitting.

If your tonsil stones are painful, or if you’re concerned that they may signal a more serious medical condition, consult with a medical professional. If you are in the Southern California area and would like a consultation with a specialist, call (800) USC-CARE (800-872-2273) or visit ent.keckmedicine.org/request-an-appointment to schedule an appointment.

By Heidi Tyline King